• Utilization Review Nurse

    The County of Los Angeles (Los Angeles, CA)
    …Considerable ambulation may be involved. SPECIAL REQUIREMENTS INFORMATION: * An Utilization Review Nurse is an RN that has Case Management experience ... OPTION II: Two (2) years of experience as a registered nurse , of which one year must...the County of Los Angeles, a Utilization Review Nurse is an RN ...Los Angeles, a Utilization Review Nurse is an RN that has Case… more
    The County of Los Angeles (08/18/25)
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  • Utilization Review Nurse

    The County of Los Angeles (Los Angeles, CA)
    UTILIZATION REVIEW NURSE SUPERVISOR...CERTIFICATE(S) REQUIRED: A current license to practice as a Registered Nurse issued by the California Board ... II Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/2784979) Apply  UTILIZATION REVIEW NURSE SUPERVISOR II Salary $118,457.04 -… more
    The County of Los Angeles (06/28/25)
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  • Registered Nurse

    Beth Israel Lahey Health (Boston, MA)
    …people's lives.** Position Summary: In conjunction with the admitting/attending physician, the Utilization Review RN assists in determining the appropriate ... billed. Conducts concurrent reviews as directed in the hospital's Utilization Review Plan and review ...required and directed. **Qualifications:** _Required_ + Licensure as a Registered Nurse ( RN ), Massachusetts +… more
    Beth Israel Lahey Health (09/10/25)
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  • Staff Nurse - Utilization

    Minnesota Visiting Nurse Agency (Minneapolis, MN)
    …require up to*Every Other Weekend*coverage/. *_SPECIFIC RESPONSIBILITIES:_* The Utilization Review (UR) Registered Nurse is responsible for evaluating ... /*License/Certifications:*/ * Possession of a valid license as a Registered Nurse issued by the State of... issued by the State of Minnesota. **Title:** *Staff Nurse - Utilization Review * **Location:**… more
    Minnesota Visiting Nurse Agency (09/13/25)
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  • Utilization Review Manager

    Minnesota Visiting Nurse Agency (Minneapolis, MN)
    *_SUMMARY:_* We are currently seeking a* Utilization Review Manager* to join ourTransitional Care Team.Thisis a full-time role. *Purpose of this position: ... *Manages the design, development, implementation, and monitoring of utilization review functions. Oversees daily operations, which include supervising staff… more
    Minnesota Visiting Nurse Agency (08/08/25)
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  • Utilization Review Medical Director

    Commonwealth Care Alliance (Boston, MA)
    …Group **Position Summary:** Reporting to the Senior Medical Director of Medical Policy and Utilization Review , the Utilization Review Medical Director ... our rapidly growing membership. The incumbent will have significant experience with utilization review , ideally experience with public programming, and excellent… more
    Commonwealth Care Alliance (09/05/25)
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  • Clinical Utilization Review

    Community Health Systems (Franklin, TN)
    …Knowledge of HIPAA regulations and patient confidentiality standards. **Licenses and Certifications** + RN - Registered Nurse - State Licensure and/or ... **Job Summary** The Clinical Utilization Review Specialist is responsible for evaluating the necessity, appropriateness, and efficiency of hospital services to… more
    Community Health Systems (09/03/25)
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  • Utilization Review Specialist

    Emory Healthcare/Emory University (Atlanta, GA)
    …**Description** The ** Utilization Review (UR) Specialist** is a Registered Nurse responsible for conducting thorough medical necessity reviews to assist ... experience or a minimum of two years of previous utilization review experience. + Must have a... experience. + Must have a valid, active unencumbered Registered Nurse license approved by the Georgia… more
    Emory Healthcare/Emory University (09/13/25)
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  • Utilization Review Case Mgr CMC-…

    UTMB Health (Webster, TX)
    …testing is also required. **_REQUIRED EDUCATION/EXPERIENCE_** **:** + Current Texas licensure as a Registered Nurse ( RN ).with a minimum of three (3) years ... Utilization Review Case Mgr CMC- Clear... Utilization Review Case Mgr CMC- Clear Lake Center **Webster,...transfers and admissions from the prison facility. + Conducts nurse to nurse conference calls for all… more
    UTMB Health (09/14/25)
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  • Utilization Review Clinician

    Monte Nido (Miami, FL)
    …while providing the opportunity for people to realize their healthy selves. ** Utilization Review Clinician** **Monte Nido** **Remote** **Monte Nido has been ... within an intimate home setting. We are seeking a Utilization Review Clinician to join our team...providing direct care to individuals with an eating disorder preferred. + Licensed behavioral health clinician/provider, RD, or RN more
    Monte Nido (09/06/25)
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  • Manager - Utilization Review

    Beth Israel Lahey Health (Plymouth, MA)
    …a job, you're making a difference in people's lives.** Full Time **Job Description:** ** Utilization Review & Denials management manager - Full Time** **Who We ... Our Team of Experts and Serve Your Community!** **In your role as a Utilization Review & Denials Management Manager, you will:** + Directs staff performance… more
    Beth Israel Lahey Health (07/29/25)
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  • Utilization Review Specialist

    BriteLife Recovery (Englewood, NJ)
    What you will be doing? The Utilization Review (UR) Specialist is a critical member of the administrative team at Advanced Revenue Solutions and is responsible ... for overseeing and coordinating all aspects of utilization review and insurance authorization for clients...a related field required; advanced degree or licensure (eg, RN , LCSW, LPC, LMHC, or CADC) preferred. + Excellent… more
    BriteLife Recovery (09/02/25)
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  • Registered Nurse 1 Psychiatric (NY…

    New York State Civil Service (New York, NY)
    NY HELP Yes Agency Mental Health, Office of Title Registered Nurse 1 Psychiatric (NY HELPS), New York State Psychiatric Institute, Utilization review , ... York State NY Zip Code 10032 Duties Description The selected candidate will provide Utilization Review services, including but not limited to conducting daily … more
    New York State Civil Service (08/14/25)
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  • Utilization Review Clinician…

    Centene Corporation (Springfield, IL)
    …Family Therapist (LMFT) required or + Licensed Mental Health Professional (LMHP) required or + RN - Registered Nurse - State Licensure and/or Compact State ... and substance abuse preferred. Knowledge of mental health and substance abuse utilization review process preferred. Experience working with providers and… more
    Centene Corporation (08/21/25)
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  • Manager, Utilization Review

    Children's Mercy Kansas City (Kansas City, MO)
    …+ Experience in Utilization Review + One of the following: Licensed RN - MO, Registered Nurse Multistate License Missouri required upon hire + ... training oversight of programs and services. Responsible for effective utilization review and proper resource management of...One of the following: Licensed RN - Kansas, Registered Nurse more
    Children's Mercy Kansas City (06/17/25)
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  • Registered Nurse

    Ascension Health (Baltimore, MD)
    …Provide health care services regarding admissions, case management, discharge planning and utilization review . Responsibilities: + Review admissions and ... planning needs with healthcare team members. + May prepare statistical analysis and utilization review reports as necessary. + Oversee and coordinate compliance… more
    Ascension Health (09/13/25)
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  • Utilization Review RN PRN

    Saint Luke's (Kansas City, MO)
    **Job Description​** The Utilization Review RN is responsible for assuring the receipt of high quality, cost efficient medical outcomes through ... utilization review and management. This position includes...billing. **Job Requirements** Applicable Experience: Less than 1 year Registered Nurse - Various Associate Degree **Job… more
    Saint Luke's (08/21/25)
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  • Registered Nurse

    HonorHealth (AZ)
    …of communities across Arizona. Learn more at HonorHealth.com. Responsibilities Job Summary The Utilization Review RN Specialist reviews and monitors ... Registered Nurse in an acute care setting - RequiredLicenses and Certifications Registered Nurse ( RN ) State And/Or Compact State Licensure - Required… more
    HonorHealth (08/22/25)
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  • Utilization Review Nurse

    US Tech Solutions (Chicago, IL)
    …and implementation of QM Work Plan Activities **Experience:** + 3+ years of experience as an RN + Registered Nurse in state of residence + Must have prior ... Authorization? + Do you have experience with Utilization Review ? + Do you have an Active Registered Nurse License? **About US Tech Solutions:** US Tech… more
    US Tech Solutions (07/18/25)
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  • Utilization Review Clinician - ABA

    Centene Corporation (Tallahassee, FL)
    …Family Therapist (LMFT) required or + Licensed Mental Health Professional (LMHP) required or + RN - Registered Nurse - State Licensure and/or Compact State ... assess ABA Treatment Plans required. Knowledge of ABA services and BH utilization review process required. Experience working with providers and healthcare… more
    Centene Corporation (08/23/25)
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